How to Prevent Priapism Caused by Trimix

Priapism is an erection which lasts more than 4 hours and is unrelieved by ejaculation. This condition is a true urological emergency and early treatment allows the best chance for functional recovery. Failure to manage this issue can result in penile fibrosis that may increase the risk of curvatures or impaired penile blood flow that may lead to erectile dysfunction.

How to prevent priapism when using Tri-Mix or other penile injection therapies (ICP):

· NEVER use Tri-Mix or any ICP injection within same 24hr period as Viagra/Cialis/Levitra or other ED meds. · Start LOW and go SLOW with your dose. Never start higher than 0.05-0.12ml (5-12 units on syringe) for the FIRST injection. Then gradually increase from there for optimal results.

If priapism occurs:

–Apply ice to perineum/scrotal area– You can use a frozen bag of fruit or vegetables if an ice pack is not available. –Walk/jog upstairs– This can help redirect blood flow from the penis.

Over-the counter medications to take:

–Sudafed (pseudoephedrine) is a decongestant available without a prescription but “behind the counter”, meaning that you have to ask the pharmacist to get it for you. The pharmacist will ask for your identification since this drug is known to be used in the manufacture of illegal methamphetamine, so the government keeps track of frequent users. Do not use other versions of Sudafed that are available since they do not have pseudoephedrine. Chew on a 30 or 60 mg tablet with water if erection has lasted more than 3 hours. Effects should start to be noticed within 30 minutes. Be aware that this drug will disrupt your sleep or may keep you awake for hours. Having sleep aids at hand can help if you are taking Sudafed at night time. 60mg-150mg orally. Note: Do not use Sudafed if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

–Benadryl – chew 25mg-50mg orally

–Amyl Nitrate: “Poppers” is another name Amyl Nitrate and is sold in “head shops”, “sex toy shops” or “smoke shops” as an “air freshener”. It is also available online. Many guys who are very experienced with ICP injections use Amyl Nitrate to treat priapism when it occurs. It is very safe if used properly. The possible side effects include headaches, decreased blood pressure and potential loss of arousal after a few minutes. It should be used with caution in men with high risk of hypotension (low blood pressure). It should not be used with ED drugs like Viagra since this may cause a sudden drop in blood pressure.

How to use amyl nitrate to treat priapism: Usually sold as “poppers”, amyl nitrate usually comes in a bottle.. Inhale over 3 seconds, wait for at least 10 minutes and inhale again once if erection does not start decreasing. Headaches and flushing are common.

Prescription medications to induce a soft penis:

Terbutaline- 10mg once, then take another 5mg-10mg 15 minutes after the first dose only if needed. If you have been prescribed Tri-Mix or any other ICP injection and are concerned about priapism you may request a prescription for Terbutaline to have on hand.

Phenylephrine: Some physicians provide you with a prescription of “Priapism rescue kit” with 2mL pre-diluted Phenylephrine HCl 0.1% (1mg/mL) vials that you may obtain with your first prescription of Tri-Mix from a compounding pharmacy. Typical protocol is 0.5mL every 5 minutes up to 2mL until detumescence (soft penis) starts

If these options do not work and erection has been present for 4hrs and/or is painful then immediately visit the closest emergency room for treatment.

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